American Psychiatric Association Tipsheet - December

December 01, 1998

Journal articles highlighted in this tipsheet are available in their entirety by calling APAfastFAX at 888-357-7924 and selecting the appropriate document number (listed below).

Persons With Mental Disorders More Often Denied Care
Restrictions on specialized services and out-of-pocket expenses still present barriers to medical care for people with mental disorders. According to analysis of data from the 1994 National Health Interview Study in the December issue of the American Journal of Psychiatry, persons with mental illnesses were twice as likely as those without to report having unmet needs for medical care. Although the Health Insurance Portability Accountability Act of 1996 was designed to improve this situation, people diagnosed with mental disorders were twice as those without to report having been denied insurance because of a preexisting condition or to have stayed in a job for fear of losing benefits. ["Mental Disorders and Access to Medical Care in the United States," by Benjamin G. Druss, M.D., M.P.H.,, p. 1775] APAfastFAX# 6901. Please direct media inquiries to Dr. Druss at

Managed Care Carve-out Decreases Costs in Massachussetts
A study of costs and utilization of services before and after implementation of a managed behavioral healthcare carve-out plan for Massachusetts state employees and their dependents in 1993 shows a significant decrease in spending per episode of care in both inpatient and outpatient facilities. According to a study in the December issue of Psychiatric Services, the decrease was largest for inpatient care, 54 percent. Costs for episodes involving both inpatient and outpatient care fell by 46 percent, and costs for outpatient episodes were 21 percent lower. The most common disorders seen were major depression and substance abuse. ["How a Managed Behavioral Health Care Carve-Out Plan Affected Spending for Episodes of Treatment," by Haiden A. Huskamp, Ph.D.] APAfastFAX# 6902. Please direct media inquiries to Dr. Huskamp at 617-432-0838; e-mail

Patients With Down's Syndrome Can Attempt Suicide
Persons with mental retardation experience episodes of major depression and have thoughts of suicide, although impaired intellectual ability may limit the success of plans for suicide. Because many suicidal acts are impulsive and do not require extensive planning ability, caregivers are concerned. Cases studies of 19 individuals with Down's syndrome evaluated for psychiatric disorders between 1985 and 1995 are examined in the December issue of Psychiatric Services. ["Two Cases of Suicide Attempt by Patients With Down's Syndrome," by Anne DesNoyers Hurley, Ph.D., p. 1618] APAfastFAX# 6903 Please direct media inquiries to Dr. Hurley, 617-636-8763; e-mail,
The text of this tipsheet (APAfastFAX #6161) and other materials for media are available in electronic formats:; Compuserve's Journalism Forum (go jforum); APA's website; APAfastFAX at 888-357-7924 (select the document number). Other APA materials for media are also available through APAfastFAX -- call for the menu. For more information on these topics or other areas of interest, contact Erin Murphy, APA Media Assistant, (202) 682-6324, e-mail:

The American Psychiatric Association is a national medical specialty society, founded in 1844, whose 42,000 physician members specialize in the diagnosis and treatment of mental and emotional illnesses and substance use disorders.

American Psychiatric Association

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